A89 EXPLORING THE ENDOSCOPY SEDATION EXPERIENCES OF INDIVIDUALS WITH PEDIATRIC-ONSET INFLAMMATORY BOWEL DISEASE (IBD) AFTER THE TRANSITION TO ADULT CARE: A PILOT STUDY
Bibliographic record
Abstract
Abstract Background Different sedation practices are utilized in pediatric and adult endoscopy settings. While pediatric endoscopies are performed under deep sedation, adult endoscopies are often performed under conscious sedation. Purpose This study sought to explore the experiences of patients with pediatric-onset IBD that have undergone transfer to adult care and to identify gaps in endoscopy sedation practices that may inform a larger and more comprehensive evaluation of this topic. Method A pilot study was performed at Women's College Hospital involving patients aged 18 to 25 years old with a diagnosis of pediatric-onset IBD that received endoscopies in both the pediatric and adult setting. Patients were recruited between June 1 and October 1, 2022. A 36-item questionnaire was distributed assessing sedation methods used in pediatric and adult settings, anxiety, pain, satisfaction during endoscopy and perceptions of transition of care preparation as it pertained to endoscopy. This study was reviewed by institutional authorities at WCH and was deemed not to require REB approval. Result(s) Twelve patients participated in the pilot survey study (7 Ulcerative colitis, 5 Crohn’s disease) with a mean age of 22. Of those, 100% were female and 66% did not have any comorbid conditions. The mean age of diagnosis was 12.8 years, with respondents spending an average of 67.3 months in pediatric care prior to transition. In pediatric care, the mean number of endoscopies received was 2.3 with a majority performed under deep sedation (83%). Respondents reported being very satisfied with their sedation experience (58%) and experiencing no pain (67%), however mild to severe anxiety was reported (58%). In adult care, mean endoscopies received was 2.1, with conscious sedation (50%) performed more often than deep (42%) or no sedation (8%). More respondents reported satisfaction with deep sedation (100%) than conscious sedation (67%). During conscious sedation, respondents experienced more pain (50% vs. 20%), moderate discomfort (33% vs. 0%), and were more anxious (83% vs. 60%) than in deep sedation. Factors that contributed to anxiety included fear of endoscopy and insufficient sedation. Of those who received deep sedation in the adult setting, 60% reported that the sedation method utilized impacted their future willingness for endoscopy. Lack of communication regarding sedation method, poor experiences with conscious sedation, and the desire to choose the sedation method appropriate for them were areas for improvement. Conclusion(s) This pilot study demonstrated that IBD patients transferred to adult care receive varying endoscopy sedation methods and experience differential levels of satisfaction favouring deep sedation. This is an important signal that requires larger study. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".